Robotic Assisted Laparoscopic Splenic Artery Aneurysm Resection

Abstract

Splenic artery aneurysms (SAA) are the most common visceral aneurysm and may develop significant risk for rupture and life-threatening complications when more than 3 cm, in pregnancy, or if resembling pseudoaneurysms. Traditional treatment options of open surgical repair and endovascular repair have been extensively studied, but the role of robotic-assisted laparoscopic surgery in definitively managing SAA is emerging as a promising minimally invasive alternative in select pathology. This case aims to present the technical details, challenges, and outcomes of an SAA in a young woman treated with robotic-assisted laparoscopic resection, highlighting the feasibility and efficacy of this approach. A 38-year-old woman with no significant past medical history was incidentally found to have a distal third splenic artery aneurysm measuring 2.2 cm in diameter and was referred to a vascular surgery clinic for further evaluation. Although she was not pregnant at the time, she was undergoing fertility treatments with plans for assisted pregnancy. She requested definitive aneurysm treatment, wished to avoid multiple interventions, and intended to become pregnant via IVF within the coming year, making repeated axial imaging unsuitable for follow-up. Imaging evaluation revealed the aneurysm sac contained one prominent feeding artery and two highly tortuous draining branches. After providing informed consent, the patient underwent successful robotic-assisted laparoscopic excision of the splenic artery aneurysm. Robotic-assisted laparoscopic surgery represents a valuable approach for the definitive management of distal splenic artery aneurysms or aneurysms involving highly tortuous vessels, conditions historically requiring open surgical ligation, resection, or vascular reconstruction. This paper illustrates how challenging aneurysms can be precisely visualized, dissected, and managed using robotic-assisted laparoscopy with the DaVinci surgical system, highlighting key minimally invasive techniques for optimal exposure and vascular control in splenic artery aneurysm repair.